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Results Both increasing altitude and exercise significantly (P < 0.05) decreased marksmanship. The shooting scores at 4K were significantly lower than those at all other altitudes. There was a likely trend for scores at 3K to be lower than those at SL and 1K (P = 0.06 and 0.07, respectively). The shooting score at rest was significantly greater than that in all trials after exercise. Partial recovery of marksmanship after exercise occurred. Altitude and exercise both significantly reduced SaO2 and increased VR. HR did not change with altitude but increased after exercise. There was a strong positive correlation (r = 0.84) between marksmanship and SaO2. There was a strong inverse correlation (r = −0.72) between marksmanship and VR, and a modest inverse correlation (r = −0.54) between marksmanship and HR.

Conclusions Increasing altitude impaired marksmanship, with a threshold at 3000–4000 m. The decreased marksmanship was closely related to decreased arterial oxygen saturation and increased ventilation, the latter increasing movement of the chest wall.